is is very essential procedure to the patients every day practices

1. D R . A N J A L A T C H I M U T H U K U M A R A N
N U R S I N G S U P E R I N T E N D E N T
E L M C H , E R A U N I V E R S I T Y
Nutritional Screening and
Nutritional Assessment in
Hospitalized patients

2. Nutritional screening
 Nutritional screening is the first and rather quick
evaluation of a patient’s nutritional condition. The
end result of nutritional screening is to find if there
is any indication for detailed nutritional assessment
and possibly a nutritional intervention.

3. Nutritional assessment
 Nutritional assessment is an in-depth evaluation
of a patient to identify and quantify specific
nutritional needs and intervention. The end result of
nutritional assessment is a nutritional plan which is
based upon specific nutritional problems of the
patient.

4. Policy for nutritional assessment
 Nutritional screening should be done for all patients admitted
in hospital and nutritional assessment is done only for
indicated patients.
 This is mandated by many regulatory and accreditation
authority across the world including NABH of India.
 While nutritional screening can be done either by a dietician,
a doctor or a nurse, detailed nutritional assessment should be
done by a qualified dietician.
 There are research evidences that nutritional needs, if not
addressed, adversely affect the treatment outcome of patient.
 Hence, a hospital that is committed to provide good quality
healthcare, must include nutritional screening and nutritional
assessment as an integral part of their clinical practices. This
is also an accreditation requirement.

5. Following important points must be
ensured for nutritional screening and
assessment.
NUTRITIONAL SCREENING
 1. Nutritional screening should be done for every admitted patient within
24 hours of admission, preferably on same day of admission.
2. In OPD patients, nutritional screening can be done selectively, such as
for patients of Obstetrics, Paediatrics, Oncology, geriatric care etc.
3. Nutritional screening should be done by a dietician or a doctor or a nurse
who has been trained for screening
4. A standard format or checklist should be used for screening. While
most parameters under nutritional screening remains same for all patients,
some additional parameters may be required for specific patients such as
cancer patient, patients on haemodialysis and paediatric patients.
The format of nutritional screening must address screening needs of all
types of patients that are served by the hospital

6. Continued
 5. The nutritional screening must include basic parameters such as height,
weight, BMI, food habit, any recent history of reduction/increase in food
intake, presence of any symptom that may indicate nutritional problems
(such as muscle wastage, generalized weakness, paleness etc.)
6. The nutritional screening should be quick but cover all necessary
parameters
7. The nutritional screening must result into the information on ‘whether
the patient needs further nutritional assessment or not’
8. If a further nutritional assessment is indicated, the dietician must be
informed, who must then conduct a detailed nutritional assessment
9. The findings of nutritional screening should be kept in the medical file of
the patient

7. NUTRITIONAL ASSESSMENT
1. Nutritional assessment should be done only for those
patients who has been identified through nutritional
screening
2. Nutritional assessment should be done by qualified
dietician
3. The assessment should be done immediately after
indicated by nutritional screening
4. Assessment points may differ depending upon type of
patient. For example, a cancer patient may have
additional assessment point

8. Continued
 5. A standard format must be used for doing
nutritional assessment. Depending upon type of
patients’ hospital is dealing with, different formats
can be used for assessing different types of patients.
6. The nutritional assessment should be detailed and
should result in a nutritional management plan

9. 7. The assessment must cover following key
points
a. Clinical and nutritional history
b. Anthropometric measurements
c. Current medications and medical tests findings
d. Physical findings focused on nutritional aspects
e. Nutritional diagnosis
f. Nutritional plan or interventions required
g. Monitoring plan
8. The assessment must be documented and kept in the
patients’ file
9. Patients should receive diet according to the nutritional
plan recommended

10. Sample Nutritional Assessment Form
A: PATIENTS' DETAILS
Name/UID: _______________________
Gender: ________ Age:______
Date of admission:_________

11. B: NUTRITIONAL HISTORY
 Diet regimen of patient:
 Diet supplements, if any:
 Food allergies:
 Age specific consideration:
 Religious or cultural food practices:
 Weight change (Yes/No): If yes whether intentional /
unintentional

12. C: ANTHROPOMETRIC DETAILS
 Height (cms):________
 Weight (kgs): ______
 Ideal Body Weight:_______
 Usual Body Weight:_______
 BMI:___________
 Condition: Very Obese / Obese / Overweight /
Adequate / Underweight

13. D: MEDICAL DETAILS
 Diagnosis (or provisional
diagnosis)_________________________
 Relevant lab findings:
____________________________
 Current
medications:______________________________
 Surgical details (if
any):_______________________________________
_____
 Any additional therapy:
__________________________________________
____

14. E: PHYSICAL FINDINGS
 Skin/Muscle wasting Hydration
status
 Edema Nausea
 Ascites Vomiting
 Diarrhoea Constipation
 Anorexia Early satiety
 Dysphagia Other

15. F: NUTRITIONAL NEEDS
 Current intake: Kcal/day________
 Protein______(grams per kg)
 Fluid ______(ml)
 Estimated nutritional
needs: Kcal/day________
 Protein______(grams per kg)
 Fluid ______(ml)

16. G: NUTRITIONAL DIAGNOSIS AND
INTERVENTION
 Problem 1: ______________________________
 Problem 2: _______________________________
 Intervention 1: __________________________
 Goal 1: ___________________________
 Intervention 2: __________________________
 Goal 2: __________________________________

17.  H: MONITORING AND RE-ASSESSMENT
PLAN:



18. F: SIGNATURE DETAILS
 Assessed by: ___________________________
Date of assessment: ____________________
 Time of assessment: __________________
Signature: ___________________________


19. Conclusion
 Nutritional assessment is one of the basic necessary
of every human being in their life . So every one need
to fulfill the requirement of nutrition in day today
life must be follows .